Posts for: September, 2011

A recent consumer survey by the AAP revealed the following:
50% of all respondents consider the smile the first facial feature they notice
80% of all respondents are not happy with their smile
Respondents were seven times more likely to smile enhancements than a facelift
Smile enhancement procedures outnumber eyelid surgeries 5 to 1

A 24-year-old Cincinnati father died from a tooth infection this week because he couldn't afford his medication, offering a sobering reminder of the importance of oral health and the number of people without access to dental or health care.

According to NBC affiliate WLWT, Kyle Willis' wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.

When his face started swelling and his head began to ache, Willis went to the emergency room, where he received prescriptions for antibiotics and pain medications. Willis couldn't afford both, so he chose the pain medications.

The tooth infection spread, causing his brain to swell. He died Tuesday.

Calls to Willis' family were not immediately returned. University Hospital in Cincinnati, where Willis was admitted, did not comment, citing federal privacy laws.

"People don't realize that dental disease can cause serious illness," said Dr. Irvin Silverstein, a dentist at the University of California at San Diego. "The problems are not just cosmetic. Many people die from dental disease."

Willis' story is not unique. In 2007, 12-year-old Deamonte Driver also died when a tooth infection spread to his brain. The Maryland boy underwent two operations and six weeks of hospital care, totaling $250,000. Doctors said a routine $80 tooth extraction could have saved his life. His family was uninsured and had recently lost its Medicaid benefits, keeping Deamonte from having dental surgery.

"When people are unemployed or don't have insurance, where do they go? What do they do?" Silverstein said. "People end up dying, and these are the most treatable, preventable diseases in the world."

Getting access to dental care is particularly tough for low-income adults and children, and it's getting tougher as the economy worsens. In April, the Kaiser Family Foundation reported that 33 percent of people surveyed skipped dental care or dental checkups because they couldn't afford them. A 2003 report by the U.S. Surgeon General found that 108 million Americans had no dental insurance, nearly 2.5 times the number who had no health insurance.

Trips to the dentist aren't the only expenses hard-up Americans are skipping. An August report by the Commonwealth Fund found that 72 percent of people who lost their health insurance when they lost their jobs said they skipped needed health care or did not fill prescriptions because of cost.

"People want to believe there's a safety net that catches all of these people, and there isn't," said Dr. Glenn Stream, president-elect of the American Academy of Family Physicians. He noted that it is often young men who are the most likely to lack health coverage.

Dr. Jim Jirjis, director of general internal medicine at Vanderbilt University, said people, like Willis, without access to care often die of conditions that were much more common decades ago.

"He [Willis] might as well have been living in 1927," Jirjis said. "All of the advances we've made in medicine today and are proud of, for people who don't have coverage, you might as well never have developed those."

There are a number of free dental clinics in operation around the country, where dentists volunteer to provide care to those without health insurance. But even if Willis had access to a free dental clinic, Stream said he still may not have been able to get the care he needed for his infection. "The wait is often months at these clinics, and this young man died within two weeks of his problem," Stream said.

Silverstein operates three free dental clinics in the San Diego area. "We're overwhelmed right now," he said. "We can't take any new patients."

Generally speaking, people have healthier mouths than even ten years ago. Consider the following:
Only 40% of all youth (ages 6 to 19) have experienced a cavity, down 50% from a decade ago
The proportion of people who lost all of their teeth has fallen to 25%, down from 33%
Use of dental sealants has increased 64%. More than 30% of all kids have at least on sealed tooth
Adults with a college degree have three more teeth than without a high school degree
Smokers are three times more likely to lose all their teeth than non-smokers

Socio-economic status plays a definite role in oral health:
33% of all low-income adults have untreated tooth decay compared to 16% of middle- and higher-income adults
19% of kids living in poverty have untreated tooth decay compared to 8% of wealthier kids